Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
J Hepatobiliary Pancreat Sci. 2011 May;18(3):375-9. doi: 10.1007/s00534-010-0357-2.
Endoscopic retrograde cholangiopancreatography (ERCP) and associated procedures are difficult to perform in patients with surgically altered anatomy. Recently, balloon enteroscopy (BE) has made it easier to perform ERCP in these patients. However, BE-assisted ERCP is often technically demanding and time consuming.
Spiral enteroscopy (SE), which has recently been developed, is a novel method of using a rotating overtube to pleat small bowel onto the enteroscope, thus advancing it through the lumen. We review the mechanism and efficacy of SE, especially in ERCP of patients with surgically altered anatomy, and report on the first patient to undergo ERCP using SE in Japan.
Spiral enteroscopy-assisted ERCP seems to be feasible and safe in patients with surgically altered anatomy. Additionally, SE-assisted ERCP appears to be easier to perform than other methods previously described and allows stable positioning of the enteroscope in order to perform delicate therapeutic maneuvers.
SE for ERCP is expected to be at least as useful as balloon enteroscopy in patients with surgically altered anatomy.
内镜逆行胰胆管造影术（ERCP）及相关操作在解剖结构改变的患者中难以实施。近期，球囊式小肠镜（BE）的应用使这些患者的 ERCP 操作变得更加容易。然而，BE 辅助的 ERCP 往往技术要求高且耗时较长。
螺旋式小肠镜（SE）是一种新的方法，通过旋转外套管将小肠褶皱到小肠镜上，从而将其推进肠腔。我们综述了 SE 的作用机制及疗效，特别是在解剖结构改变的患者的 ERCP 中的应用，并报道了日本首例使用 SE 进行 ERCP 的患者。
SE 辅助的 ERCP 在解剖结构改变的患者中似乎是可行且安全的。此外，SE 辅助的 ERCP 似乎比其他已描述的方法更容易操作，并允许稳定地定位小肠镜以进行精细的治疗操作。
SE 用于 ERCP 预计至少与球囊式小肠镜在解剖结构改变的患者中同样有用。
